Bascom Communications is an equal opportunity employer and does not discriminate against otherwise qualified applicants on the basis of race, color, creed, religion, ancestry, age, sex, sexual orientation, gender identify, marital status, national origin, disability, veteran status or any other status as protected by local, state or federal law.

Personal Information
Position Interest
Status Desired:
Availability
Hours Available: Sunday Monday Tuesday Wednesday Thursday Friday Saturday
Available From Sunday From Monday From Tuesday From Wednesday From Thursday From Friday From Saturday From
Available To Sunday To Monday To Tuesday To Wednesday To Thursday To Friday To Saturday To
General Information
Have you ever been employed by Bascom Communications?
Are you over the age of 21 years?
Are you legally eligibe for employment in the United States? (If employed, you will be required to provide documentation to verify eligibility)
Have you ever been convicted of a felony?
Have you ever been terminated or have you resigned in lieu of being terminated?
Are you able to perform the essential functions of the positions that you are applying for with or without accomodation?
Do you have any relatives working at Bascom Communications or Bright.net/Bascom?
How did you hear about this position?
Education and Training
Type of School Name of School/Address Graduated? Type of Degree, Diploma, Certificate and Major/Minor Area of Study GPA
High School or GED
Vocational/Technical or Two Year College
College or University
Graduate School
Other
Licensure, Certification, or Registrations
Licensure, Certification, or Registration HeldIssued ByNumberDate IssuedDate Expires
Licensure, Certification, or Registration HeldIssued ByNumberDate IssuedDate Expires
Licensure, Certification, or Registration HeldIssued ByIssued ByDate IssuedDate Expires
Licensure, Certification, or Registration HeldIssued ByIssued ByDate IssuedDate Expires
Office Skills
Computer Software Proficient in Usage:
Additional skills or other proficiencies that may be applicable to job:
Employment History - Please begin with current or most recent employer. Do not exclude any employment. Explain periods of unemployment and include U.S. Military Service. DO NOT PUT DOWN 'SEE RESUME'
May we contact your current employer?
May we contact your current employer?
May we contact your current employer?
Professional References - Please list three individuals who are not related to you or previous supervisors who can provide references.
NameAddressTelephone NumberRelationship to YouYears Known

Please read carefully before signing - Applicant's Certification and Agreement

I hereby certify that the information and facts set forth in this application are true, complete and accurate to the best of my knowledge. I understand that any falsifications, misrepresentations or omissions of any facts in this application or other documents submitted for consideration of employment will be cause for denial of employment or immediate termination of employment, if employed regardless of the timing or circumstances of discovery.

I understand that if I am hired this Application becomes a part of my official employment record.

I authorize Bascom Communications to verify the accuracy of any information provided or known. I hereby authorize any and all schools, employers, references, regulatory boards, courts and any others who have information about me to provide such information to Bascom Communications and/or any of its employees, representatives, agents or vendors. I release all parties involved in this process from any liability for any and all damage that may result from providing such information.

I understand that if offered a position, I may be required to submit to a pre-employment drug screening and criminal background check and Driver’s License check (where applicable) as a condition of employment. I further understand that I may be required to complete a pre-employment physical exam depending upon the position offered. I understand that receipt of unsatisfactory results from, failure to complete as required or any attempt to affect the results of these, will result in the immediate withdrawal of any offer of employment or the termination of employment, if already employed.

I understand that submission of an application does not guarantee employment. I further understand that should an offer of employment be made by Bascom Communications, such offer whether or not stated is for employment at will, and that if I accept such offer, my employment may be terminated by either Bascom Communications or myself at any time, with or without cause or notice. I understand that none of the documents, policies, procedures, actions, or statements of Bascom Communications or its employees or representatives used during the hiring process or during my employment may be deemed to be a contract for employment, either actual or implied. I understand that no employee or representative, other than the General Manager of Bascom Communications, has the authority to enter into any agreement contrary to the above and that any such agreement if made shall not be binding unless it is set out in a writing signed by the General Manager.

I agree that any claim or lawsuit relating to my service with Bascom Communications must be filed no more than six (6) months after the date of the employment action that is the subject of the claim or lawsuit. I waive any statute of limitations to the contrary.

In consideration of employment, if offered, I agree to abide by and adhere fully to all rules, regulations, policies and procedures of Bascom Communications at all times. I further understand that Bascom Communication’s rules, regulations, policies and procedures may be changed at any time, with or without notice.

Enter your name and today's date to indicate your acceptance of the agreement